BMS1042 Lecture Notes - Lecture 1: Belle Gibson, Mastectomy, Brca2
20 Jun 2018
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FOUNDATIONS
1. THIS IS PUBLIC HEALTH
Introduction
Public Health is the transition between clinical research and the public. It’s about doing the
research, doing the stats, and ultimately implementing a public health initiative to help improve
an outcome. Without accurate data, there is no effective initiative.
Understand the public health issues that surround you
Case study: Ms Jolie was genetically tested and discovered she had both the BRCA1 and
BRCA2 gene. When these genes mutate, they significantly increase the likelihood of breast and
ovarian cancer. In addition, she had a family history of breast and ovarian cancer. To avoid the
metastasization of these cancers, she underwent a double mastectomy and had her ovaries
removed.
The problem arose when she, with such a high following, announced it in public and began
giving medical advice. Being such a strong influencer, the company who did Ms Jolie’s
mastectomy grew 4% in shares overnight and women became more concerned with their health
and genes.
This was worrying because medicine had not yet developed a system where any increases in
developing cancer could be meaningfully interpreted and acted on by doctors. Sure, we can say
you have a 33% increase in developing breast cancer, but what does that actually mean? Did it
jump from 1% to 1.33%, or from 60% to 80%? Also, some cancers are not even harmful and our
diagnostic devices have yet to distinguish harmful cancers from dormant ones.
It is critical to assess the quality of evidence behind every medical claim, and look at the
relative risk.
Case study: Belle Gibson, a fake wellness blogger propagandised the ditching of conventional
medicine for healthy foods and claimed she had cured herself of cancer. However, she did not
have cancer and judge ruled that she ‘deliberately played the Australian public’.
Public health issues affect us everyday. From UV exposure, to water quality and availability, to
air quality like pollutants, and nutrition and food security.
But how do we actually tackle these problems?
The key is to make the healthy choice the easy choice.
E.g Piano stairs increased people taking the stairs by 66%
Cleaver healthy campaigns
E.g Dumb ways to die
Prevention and surveillance
E.g washing hands and preventing the spread of disease.
Be able to identify the main areas of public health in a current and historical context
The practice of public health aims to
- Improve the health of an entire population
- Reduce health inequalities in a population
- Step beyond the individual-level focus of mainstream medicine
Document Summary
Public health is the transition between clinical research and the public. It"s about doing the research, doing the stats, and ultimately implementing a public health initiative to help improve an outcome. Without accurate data, there is no effective initiative. Understand the public health issues that surround you. Case study: ms jolie was genetically tested and discovered she had both the brca1 and. When these genes mutate, they significantly increase the likelihood of breast and ovarian cancer. In addition, she had a family history of breast and ovarian cancer. To avoid the metastasization of these cancers, she underwent a double mastectomy and had her ovaries removed. The problem arose when she, with such a high following, announced it in public and began giving medical advice. Being such a strong influencer, the company who did ms jolie"s mastectomy grew 4% in shares overnight and women became more concerned with their health and genes.
